The Pending Epidemic That No One's Heard About: LADA Diabetes

For
1500 years, from about 400-500AD to the very recent past, diabetes has
fit neatly into one of two categories. Type 1 was associated with
childhood, insulin-dependence, and (eventually) with autoimmune
disorders. Type 2, on the other hand, was something that you got in
adulthood, didn’t always need to constantly take insulin for, and could
generally be controlled with diet and exercise. Of
course, there were other types of diabetes during that time too:
gestational diabetes, which affects women during pregnancy and often
disappears completely after childbirth, along with many other sub-types
and specific cases. And for a long time, it was thought that these
sub-types made up a tiny percentage of all diabetes cases worldwide.
Then along came LADA.

LADA, or Latent Autoimmune Diabetes in Adults, is a very
special subtype of diabetes. For one thing, it affect a shockingly high
amount of people – some estimates put it at 10% of all diabetes cases
(or more than Type 1). For another thing, it shares enough qualities
with both Type 1 and Type 2 diabetes that diagnosing it becomes a little
bit of a challenge. So much so that many in the diabetes research
community have taken to calling it Type 1.5 instead of using the
‘official’ name. Like Type 1 diabetes, LADA Diabetes is increasingly
thought of as an autoimmune disorder, largely because of the presence of
autoimmune antibodies in the blood of those with the disease. These
antibodies, proteins that are left over after the immune system attacks
what it perceives to be a threat, are a clear sign that like Type 1,
Type 1.5 diabetes is caused by the body getting confused and attacking
itself. Unlike Type 1, LADA is diagnosed mostly in adults. It also does
not cause immediate dependence on insulin, and shows some signs of
insulin resistance like Type 2 does.

The Trouble With Type 1.5

For most of our readers, these technical distinctions
between types 1, 1.5, and 2 may seem trivial. Does it really matter how
each one works, so long as your doctor diagnoses it and gives you the
right treatment? Well, that’s the main problem with LADA – it can be
very hard to diagnose by a physician who hasn’t seen it before, and the
treatment it requires is quite different from Type 1 OR Type 2.

The biggest problem is that Type 1.5 diabetes most often
presents itself later in life. Unfortunately, when many physicians see
new cases of diabetes in adults, they often chalk it up to Type 2
without running tests for the autoantibodies that would clearly show it
to be Type 1 or LADA Diabetes. The patient gets their Type 2 diabetes
diagnosis, and goes on a standard diabetes fitness and dietary regimen,
which helps control blood sugar levels for a little while. When their
blood sugar gets out of control again, they are given Lantus insulin, a
typical treatment for people with Type 2 who require insulin. Still, the
blood sugar continues to rise, and finally, after a long struggle and
many frustrations, the patient is placed on the full basal/bolus regimen
like those with Type 1 diabetes.